Laparoscopic approach in the treatment of epiphrenic diverticula: long-term results
- 117 Downloads
Thoracotomy represents the traditional surgical approach for the treatment of epiphrenic diverticula. A mini-invasive procedure has been reported in only few series. This article describes the authors’ experience with the laparoscopic approach for performing diverticulectomy, myotomy and Nissen–Rossetti fundoplication.
From 1994 to 2002, 13 patients (6 men and 7 women), mean age 57 years (range 45–71 years), with symptomatic epiphrenic diverticulum underwent laparoscopic diverticulectomy, myotomy, and Nissen–Rossetti fundoplication.
The mean operative time was 145 min (range 110–180 min). No operative mortality was observed. The mean hospital stay was 13.9 days (range 7–25 years). The first three patients (23.1%) who underwent surgery experienced a partial disruption of the suture staple line. One patient (7.7%) died of a myocardial infarction. After a mean clinical follow-up period of 58 months (range 3–96 months), all the patients were symptom free.
Laparoscopic management of epiphrenic diverticula seems to be as safe and effective as the traditional approach, although a longer follow-up period is necessary to confirm the study results.
KeywordsDysphagia Esophageal manometry Epiphrenic diverticulum Laparoscopy Antireflux procedure
- 6.Del Genio, A, Izzo, G, Maffettone, V, Di Martino, N, Fei, L, Zampiello, P, Allaria, A, Nuzzo, A 1994What is the degree of obstruction to swallowing created by the Nissen valve?Giuli, RTytgat, GNJDeMeester, TRGalmiche, JP eds. Esophageal mucosa.Elsevier Science Publishers BVAmsterdam623629Google Scholar
- 12.Mondiere, JT 1833Notes sur quelques maladies de 1’oesophage.Arch Gen Med Paris32865Google Scholar
- 16.Peracchia, A, Bonavina, L, Rosati, R, Bona, S 1994Thoracoscopic resection of epiphrenic diverticula.Peters, JMeester, TR eds. Minimally invasive surgery of the foregut.QMP IncSt. Louis110116Google Scholar
- 20.Santy, P, Michaud, P, Viard, H 1958Les diverticules associés au megaesophage.Ann Chir12512519Google Scholar
- 21.Skinner, DB, Belsey, RH 1988Esophageal spasm and diverticulum.Management of esophageal disease.WB SaundersPhiladelphia431452Google Scholar